Botox and Antibiotics - a Bad Combination - Australia

I was taking a tetracycline antibiotic...

23 Jul 2009

I was taking a tetracycline antibiotic (doxycycline) when I had 15 units (total) of Botox injected. I had been taking the 25-day course of doxycycline for 18 days before the Botox and 7 days after the Botox. I had the Botox injections on 10 July.

The Botox was put in my frown lines, above my eyebrows, in crows feet area, in bunny lines and one under the eyelashes of my left eye. A total of 9 injections and a total of 15 units. Not much. I have had Botox twice before - Oct 08 and April 09.

It would appear that the antibiotic increased both the physical impact and the side effects of the Botox. The other two times I have used Botox I had similar amounts administered (around 15 units) in the same places and I had stable results in around 5-7 days. The muscles were relaxed but not frozen.

It has now been 14 days since the last injections and the Botox is still paralysing my muscles. My forehead is cement, both sides of my face have dropped, my brow is lowered and upper eyelids swollen. I have puffy bags / pouches underneath my eyes because the complete freezing of the eye muscle in both the crows feet and bunny lines areas means that the area under my eyes has nowhere else to move except inwards, particularly when I make a facial expression. I have the 'chipmunk' look when I smile because the sides of my face can't move anymore. (I have no reason to smile anyway.)

I also had severe side effects (see other posts), which has never happened before. Previously I had mild side effects for a few days - headache, a bit of anxiety etc. This time it has been very severe and very debilitating.

I have reported the adverse outcome to the FDA in the US and to Allergan in Australia but was informed that interaction with antibiotics such as tetracyclines and aminoglycoside antibiotics is "THEORETICAL" because no clinical testing has been done. Therefore, no data is available and nobody can tell me what is going to happen. It is clear that the Botox effect has been dramatically increased by the antibiotics, but I am very worried that the duration of the effect will also last longer. I am hopeful this is not the case. Has anyone else had a similar experience with Botox and tetracycline antibiotics?

Has anyone with a bad Botox result used anything...

31 Jul 2009

Has anyone with a bad Botox result used anything like the Tua Viso to try to stimulate the deadened muscles once they started to re-engage? In my previous Botox experiences (which might be different this time because of the antibiotics) the muscles started to move again in around six weeks. The movement was weak but it was definitely there.

Would using an electric muscle stimulator assist the newly re-engaged muscles to strengthen and therefore correct the bad result more quickly? I am very wary of doing anything to make it worse so advice would be appreciated. My Botoxed muscles are still completely dead so I have a few weeks before I could even try this. Does anyone have any thoughts or experience with this?

I have asked the doctors about the Tua Viso to...

28 Aug 2009

I have asked the doctors about the Tua Viso to speed up the recovery from my bad botox result. Hopefully I will get an answer!

MASSIVELY LONG UPDATE WITH PHOTOS AT 38 WEEKS POST...

4 Apr 2010

MASSIVELY LONG UPDATE WITH PHOTOS AT 38 WEEKS POST BOTOX

THE RISKS OF BAD AESTHETIC RESULTS FROM BOTOX ARE *NOT* LIMITED TO UPPER EYELID PTOSIS - Eyelid ptosis is generally stated to be the only ‘rare’ aesthetic complication of Botox. And why is that? Because it is the only one that cannot in any way be passed off as natural ageing. Let me assure you, Botox can do a whole lot worse than that. Here are some examples that are easy for doctors to pass off as natural ageing or tell you it is 'all in your mind': hourglass deformity (caved in temples), cheek ptosis (cheek drop), full facial drop including increase in severity of nasolabial folds, festoon formation (bulging fat pads under the eyes), tear trough deformity (increased hollowing under the eyes), increase in wrinkles especially horizontal wrinkles around the eyes (starburst effect), brow drop (caveman forehead), sunken eyes. Here are some that are not so easy to pass off as natural ageing: crooked smile, mouth drop, exacerbated asymmetry, the appearance of palsy or a stroke. I probably haven't listed them all, so feel free to add more...

I find it simply incredible that doctors will *promote* Botox as having the ability to change facial shape when it suits them, like using Botox to deliberately diminish a pronounced masseter muscle and slim the face, BUT when they make a mistake and change facial shape for the worse through cheek ptosis, face drop or hourglass deformity then they deny this is possible. It is just nonsense and they can't have it both ways.

MY AESTHETIC RESULT FROM BOTOX - Festoon formation under the eyes (particularly left eye) from overweakening of the eye muscle which enabled the fat pads under my eyes to bulge forward. See photos - both were taken with makeup on in my office under the fluorescent light. Without makeup, the area under my eyes is black. The photos do not do justice to how bad my result has been - they are just ONE aspect of it that seemed the easiest to photograph. Any animation of my face, especially smiling or laughing, causes this festoon to puff out more and the skin to wrinkle/bunch/fold around my eyes. (The rest of my bad result requires motion and it is difficult to photograph to show it. I wish I had taken video.)

My awful result includes cheek ptosis because of Botox in the crows feet area which caused the lower part of my eye muscle to flatten out like a pancake across my cheek bone and the facial fat to droop down my face. I also got mid-face drop from Botox in the bunny lines area (under the eyes on either side of the nose) which caused a flattened appearance to the mid-face, divots on either side of my nose and an increase in nasolabial lines. All of these bad aesthetic outcomes were extreme. I also got a mild form of hourglass deformity in the temple area which I didn't notice until it basically resolved because I was so focused on the other ghastly results, but I can see it now in the photos. The worst part was how badly it has affected my smile. I have the starburst appearance around the eyes and my inability to lift my face properly because of the cheek ptosis means that my cheeks puff out like a chipmunk on smiling , the area under my eyes all bunches up with folds of loose skin and I get divots/depressions on either side of my nose and on the sides of my face. This did NOT happen before Botox. I have not smiled or laughed without my hands in front of my face for 38 weeks.

"NATURAL AGEING" - When Botox makes you look old and haggard and gives you more wrinkles, doctors will tell you that it is natural ageing or that it is 'all in your mind' or that Botox can't do that. You know this is rubbish but how do you prove it? Botox gone bad is the most visible when the face is in motion and still photos will not properly show the difference. I suggest you have photographs taken before Botox with a range of facial expression - still, smiling, frowning - and from a range of angles - front, above, 3/4 angle etc. Better yet, take a before video instead of photographs. I wish I had.

Have a look at my photo from week 3 when the puffy eye bag was at its worst and look again at week 37. It has still not completely resolved but it is certainly better. I was repeatedly told that this festoon which appeared ONLY after Botox was natural ageing, meaning it could never get better. Ageing like that in 3 weeks?? I don't think so. If that were true then the only explanation now is that I have "un-naturally un-aged". Medical miracle? I think not. It was not rapid ageing; it was Botox.

DO NOT HAVE TWO PROCEDURES DONE AT ONCE - I have referred to Botox in my case as the dermatologists' equivalent of "Do you want fries with your burger?" because I was upsold on Botox to make the filler last longer. I never asked for Botox in the first place. It was a massive mistake having two things done at once because when something went wrong, I could not properly ascertain the problem. I thought the puffiness under my eyes was related to the dermal filler I had put in at the same consultation. I had the filler dissolved (unnecessarily) because the doctors were unable to recognise and properly diagnose my bad Botox result, or they did recognise it and lied about it - I still can't decide. Dissolving the filler with hyaluronidase came with a whole host of other problems that have not resolved either. Just excellent.

TIME FRAME FOR RECOVERY - Doctors will tell you that the effects of Botox last 3-4 months, maybe 6 months. This is a MARKETING ploy to get you to have Botox more often. The effects last much longer than that if you want them to go away completely, particularly if is not the first time you have had Botox. I did not even begin to see improvement until week 26 when I felt the first glimpse of the muscle across my cheek bone start to puff back out. It has now been 38 weeks and I have not yet recovered. Also, the EFFECTS OF BOTOX ARE CUMULATIVE because most people have it again before the previous lot has worn off. If you are having Botox every 3-4 months in the same places in the same amounts then you are at even greater risk of the eventual disaster. Lots of people describe the same pattern with Botox - good result, good result, good result, HORROR STORY. Some people get the horror story on the first go. Others continue to have good results for a long time without the horror story, and I have my fingers crossed for them that it continues that way. I would not wish this on my worst enemy.

BOTOX AFFECTS SKIN AS WELL AS MUSCLE - The facial muscles are unique in that they are connected to the skin. Botox initially makes the skin on foreheads tight and shiny then the skin loosens up as the Botox wears off. If you get face drop or cheek ptosis then you can expect massive skin laxity because the flattened, paralysed muscles cannot support the skin properly and it droops and sags downwards. I had Botox shiny 'glass' face for more than 5 months then the skin loosened up horribly. It has tightened up some now but it is crepey with short diagonal wrinkles down my cheeks as well as the bunching effect and new wrinkles under my eyes. I am hopeful that the skin will tighten up some more, but I don’t know.

DO NOT PANIC AND RUSH FOR A PROCEDURE TO "FIX" IT - I am astounded by the amount of stories I have read about bad Botox results where the solution presented has been MORE Botox. We all understand the see-saw relationship between the muscles in the forehead but how on earth is more Botox going to help cheek ptosis? Easy answer - it isn't. If Botox has caused your face to drop or trashed your skin then you are an easy target to be sold another procedure like cheek filler or Fraxel etc. It was repeatedly suggested to me that I could benefit from having my cheeks 'built up' with dermal filler. Ummm... if my cheeks weren't flattened by Botox then I wouldn't need the filler, would I? Forget it!

And I cannot tell you how many times I have been tempted to have that bulge under my eye removed with a lower blepharoplasty but my patience has paid off and it is almost gone. What if I'd had a blepharoplasty after 6 months? All the doctors say Botox only lasts 6 months maximum, so I could have believed at that point that my face was the best it was going to get and had the blepharoplasty. If I had done that I would be in trouble now - probably complaining about too much fat being removed and hollow eyes because all it needed was TIME. Lots more time than I was told it would. Please wait it out a bad Botox result for a full year and then assess the damage. It will take a lot longer than you think and waiting it is the hardest thing I have ever done, but if you want your face back then more and more procedures will only get you further away from it.

HOW 'RARE' ARE THESE HORRIBLE AESTHETIC BOTOX RESULTS? - There is only one answer to that: WHO THE HELL KNOWS? There is no obligation on the injector to report bad aesthetic outcomes, so presumably they don’t. From the reports on RealSelf, patients are generally dismissed as neurotic and hysterical when something goes wrong and told it is ‘natural ageing’ or 'all in their minds' unless it is the undeniable eyelid ptosis. People often don’t have the language to describe what went wrong (no doctor told me the right words or what happened - I worked it out myself from research, research, research and sharing information with other people on this website!). And people simply don’t know how or where to report a bad aesthetic result from Botox.

I would strongly suggest that the combination of these factors means that, at the very least, undesirable aesthetic outcomes from Botox are SIGNIFICANTLY UNDER-REPORTED. I reported my bad result to the injector, other doctors, Allergan, the FDA and the TGA (Australian equivalent of the FDA). If you have had a bad Botox result, please take the time to report it. No wonder the product can continue to be marketed as ‘safe’ and ‘effective’ without challenge. Millions of good results? Says who? The doctors aren’t going to tell you their stuff ups because it would undermine your confidence in their skill as a practitioner. Allergan isn’t going to tell you because it would hurt sales of their product. Botox has a 41% NOT WORTH IT rating on this website as at this update, which speaks volumes to me and lots of those reviews are from people who have had previous success with Botox from the SAME provider.
TECHNIQUE OR PRODUCT? – Someone on RealSelf very aptly described it as a ‘crap shoot’. I agree.

IS BOTOX PERMANENT? WILL THERE BE PERMANENT DAMAGE? – I don’t know. I don’t know. All the reports say that Botox is temporary. Okay, the nerves reconnect to the muscles, which technically means it is temporary, but does this mean that the muscles will ever regain their proper shape and strength? Will they pull the skin back to where it once was? I don’t know the answer to this yet.

HOW HAS A BAD AESTHETIC RESULT FROM BOTOX MADE ME FEEL? – It has been the most isolating, debilitating and lonely experience of my life. I would not have made it without RealSelf and my heart goes out to all those others living this same nightmare. The loss of my self-confidence has affected all aspects of my life – social, personal and professional. I will never get this time back. I could use every negative adjective in the world, but I am going to choose one: devastating.

TO BOTOX USERS AND POTENTIAL USERS – Please consider this warning before having Botox.

TO BOTOX INJECTORS – Listen and learn.

Name not provided

Botox is FDA approved *only* for the glabella region and for a very good reason - it can be 'hit and miss' when used in other areas of the face. There are also aesthetic limits to Botox, particularly when it is used repeatedly. Never mix Botox with another injectable (like dermal filler) or another procedure (like laser) at the same appointment. You might not be able to work out what happened if something goes wrong. Take your time! Please inform yourself about Botox as much as you can before using it. Know the right questions to ask your providers and if they cannot answer them properly then do not proceed. The "magic miracle" of Botox can rapidly turn monstrous.